Thursday, February 28, 2013

Great moments with MRI facility reps:

Miss Lodestone: "Doctor, our new MRI exposes patients to 75% less X-ray radiation than the previous generation of scanners."

Dr. Grumpy: "MRI doesn't use X-rays. It uses magnetism."

Miss Lodestone: "Correct! Now that modern MRI no longer needs X-rays, we've been able to reduce the amount patients are exposed to in a scan."

Dr. Grumpy: "MRI has never used X-rays. Different physics."

Miss Lodestone: "That's why the new scanners have allowed us to bring it down by 75%!"

Wednesday, February 27, 2013

Suspicious minds

Annie: "Dr. Grumpy's office, this is Annie."

Mrs. Poppy: "Hi, I need to pick up my Percocet prescription for the month."

Annie: "Hang on, let me check... Actually, we have your chart flagged. We discovered earlier this week that you're getting Percocet from 5 different doctors, and having them filled at 5 different pharmacies."

Mrs. Poppy: "Well, I can explain this..."

Annie: "Dr. Grumpy has it specifically noted not to refill your narcotics."

Mrs. Poppy: "Okay, the truth is that you're right. I am getting refills from multiple doctors. But I'm not actually taking it! I just store it. You know, in case there's ever a shortage. I keep it all in a shoe box in my closet. But I swear I'm not taking any. So can't you refill them? Because I'm really not using it at all?"

Tuesday, February 26, 2013

Those be some high-fallutin words

Mr. Migraine: "I think I've figured out why I'm having headaches."

Dr. Grumpy: "What's that?"

Mr. Migraine: "My neurotransmitters are creating a pro-inflammatory non-modulating environment of excitatory free-radicals resulting in stimulation of the trigeminothalamic activating system."

Pause

Dr. Grumpy: "So, what do you think that means?"

Mr. Migraine: "Don't know. I read it on a blog."

Monday, February 25, 2013

Office silliness

Like most docs, Pissy and I have anatomy models lying around that we use to explain things to patients. Last week, while putting the cervical spine away, I dropped it, and one of the vertebrae broke in half.

No biggie. The next morning I brought in super glue from home, and carefully put it back together. Pissy walked in just as I was finishing up.


Dr. Pissy: "What are you working on?"

Dr. Grumpy: "The C-spine model. I accidentally broke a vertebrae, and had to glue it back."

Dr. Pissy: "Where?"

Dr. Grumpy: "Right here" (points to part of model) "It snapped off when it hit the floor."

Dr. Pissy: "Looks good. I can't even see the crack."

Dr. Grumpy: "Yeah, it was easy. I can't believe they pay neurosurgeons so much to do this."

Sunday, February 24, 2013

Sunday reruns

This picture was featured in a mailing I received. It's for a CME program on Parkinson's disease. It is, I swear, a DVD of 4 neurologists arguing. Yeah, because I'm just dying to watch that.



The distinguished faculty in the picture are named as (left to right) Drs. Sethi, Obeso, Olanow, and Stern.

Believe it or not, this is about as exciting as a party of neurologists gets. They sit around and discuss Parkinson's disease and other invigorating topics. And people wonder why I'm in solo practice.

I'm not convinced that's water in their glasses, either. Vodka, maybe.

Obviously, the star of the picture is Dr. Olanow. He looks like he's one step away from wearing a lampshade on his head. I'd like to think he's talking about his windsurfing trip over the summer, and how he accidentally ended up starring in an Absolut vodka commercial with the Sports Illustrated swimsuit models. More likely, though, he really is talking about Parkinson's disease. Only a neurologist can look so happy while talking about something that would scare everyone else away.

Let's try to guess what they're thinking:

Dr. Sethi: "Wow. Olanow has had too many already. He always gets the spotlight, and the hot drug reps. And what the hell did he do with my tie? As soon as I walked in he asked to borrow my tie because he forgot his, and now he isn't even wearing it. I have to remember to get the phone number for that Absolut girl who keeps refilling our glasses. I hope she saw that I drive a Porsche."

Dr. Obeso: "I have noooooo idea what they put in the vodka. I've only had 2 so far. I'm not touching it again. Holy crap, I hope I don't puke at the table. Olanow would never let me live that down. He'd probably show slides of it at next year's academy meetings. How come I'm the only one here who's wearing a tie?"

Dr. Olanow: "Man! Thish party is great! I better hit up Stern for cab fair back to the hotel, because I spent the travel stipend on the keg party last night. I hope nobody notices the tie I took from Sethi is missing. I gave it to that hot drug rep after writing my hotel room on it with her lipstick."

Dr. Stern: "I have to pee, and Olanow won't STFU. Maybe if I cross my legs. I didn't even see a bathroom when we came in. Maybe there isn't one. What do I do then? What the hell is he even talking about, anyway? Why does he need to borrow $20? He still hasn't paid me back from the last meeting. At least I have a good chance of getting laid tonight, because that sizzling drug rep gave me a tie with a room number written on it in lipstick."

Friday, February 22, 2013

Family matters

Dr. Grumpy: "Did either of your parents have any major illnesses?"

Mrs. Clueless: "I don't know. They were both adopted."

Thursday, February 21, 2013

Duuuuuuuuuuuuuuuuuuude

Dr. Grumpy: "What can I do for you?"

Mr. THC: "Well, a friend and I were smoking marijuana a few weeks ago, and I mean a lot of it. At one point, I took my pulse, and it was up to, like, 20,000 beats per minute."

Dr. Grumpy: "Is this why you're seeing a neurologist?"

Mr. THC: "Yeah, my internist sent me to a cardiologist, who sent me to you."

Dr. Grumpy: "Okay... So, 20,000 beats per minute really isn't physiologically possible. Maybe it was the effects of the marijuana."

Mr. THC: "That's what they said! But I know they're wrong! I counted them myself!"

Dr. Grumpy: "20,000 is a pretty big number to count up to in 60 seconds."

Mr. THC: "I was able to do it because time had slowed down, and that helped."

Wednesday, February 20, 2013

Drug rep quote of the day

"Wirth-Liss pharmaceuticals has an outstanding legacy of unparalleled neurological achievement, and I want to personally partner with you to help meet the lifelong goals of your epilepsy patients."

Uh, I hope you mean the prescription...

I'd like to thank the local pharmacy that faxed this note to my office last night.



Tuesday, February 19, 2013

February 19, 1942

On this day in history, Nazi Germany launched it's only successful invasion of North America. Sort of...

Winnipeg, in the Canadian province of Manitoba, is 4,307 miles from Berlin, Germany. Much farther than Hitler's more immediate enemies in Britain and Russia. Away from the Atlantic seaboard, it seemed an unlikely place for him to invade North America.

Yet, in the early-morning darkness of February 19, 1942 the city's residents were woken by gunfire. They looked out their windows to see warplanes painted with swastikas buzzing overhead, driving off the few Canadian fighters that rose to intercept them. German troops marched through the outskirts of the city, backed up by tanks. Air-raid sirens sounded, and the city was put under blackout.

Canadian defenders (composed of the Royal Winnipeg Rifles, Winnipeg Grenadiers, Veterans Guard of Canada, and others) formed in the center of the city, and were directed by telephone and signal lights. Anti-aircraft batteries opened fire on enemy planes, without success. As artillery thundered and rifles cracked, German forces gradually pushed the defenders inward. Explosions were heard in the distance, as the Germans blew up bridges that might have brought reinforcements to town.

The Canadian forces fought valiantly, but were hopelessly outnumbered. By 9:30 a.m. they'd all surrendered.


Victorious German troops drive through Winnipeg


Unopposed, Hitler's troops spread through the city. City leaders were rounded up, arrested, and taken to detention areas. Col. Erich Von Neuremburg (the German commanding officer) issued the following decrees:
  1. This territory is now a part of the Greater Reich and under the jurisdiction of Col. Erich Von Neuremburg, Gauleiter of the Fuehrer.
  2. No civilians will be permitted on the streets between 9:30 pm and daybreak.
  3. All public places are out of bounds to civilians, and not more than 8 persons can gather at one time in any place.
  4. Every household must provide billeting for 5 soldiers.
  5. All organizations of a military, semi-military or fraternal nature are hereby disbanded and banned. Girl Guide, Boy Scout and similar youth organizations will remain in existence but under direction of the Gauleiter and Storm troops.
  6. All owners of motor cars, trucks and buses must register same at Occupation Headquarters where they will be taken over by the Army of Occupation.
  7. Each farmer must immediately report all stocks of grain and livestock and no farm produce may be sold except through the office of the Kommandant of supplies in Winnipeg. He may not keep any for his own consumption but must buy it back through the Central Authority in Winnipeg.
  8. All national emblems excluding the Swastika must be immediately destroyed.
  9. Each inhabitant will be furnished with a ration card, and food and clothing may only be purchased on presentation of this card.
  10. The following offences will result in death without trial
    1. Attempting to organize resistance against the Army of Occupation
    2. Entering or leaving the province without permission.
    3. Failure to report all goods possessed when ordered to do so.
    4. Possession of firearms.
No one will act, speak or think contrary to our decrees.

Churches were closed, and all services banned. The few clergy who dared object were arrested and taken to detention camps. City buses were stopped by armed soldiers, and their passengers were searched. The city flag was replaced by the swastika, and Winnipeg itself was renamed "Himmlerstadt." German soldiers pulled books off library shelves and burned them in the street.


German soldiers confiscating papers from a newsman.

Surrounding communities were also affected. Crowds confronted German soldiers in the streets of Neepawa. Virden was taken over and renamed Virdenberg. Brandon and Selkirk were bombed by Luftwaffe planes.

As troops fanned out through Winnipeg they attacked newspaper sellers and destroyed their papers. They took over radio stations, filling the airwaves with martial music and excerpts from Hitler's speeches. The now-puppet local CBC broadcast a program called "Swastika over Canada." The Winnipeg Tribune was forced to publish an edition with a front page written in German. Canadian dollars were banned, and banks were forced to issue freshly printed Reichsmarks.

The German troops went into workplaces and restaurants and took meals from citizens. They also raided stores and police stations for heavy coats, as it was a chilly 18°F (-8 C).

At one local school the principal was arrested and replaced with a German headmaster. He distributed lessons to the students about the "Nazi Truth," explaining why Hitler's leadership was in Canada's best interests.

German soldiers leading arrested officials out of city hall.


Of course, none of this quite really happened.

The entire occupation, called "If Day," was an elaborate, and remarkably successful, campaign to sell war bonds. The planes were Royal Canadian Air Force fighters painted with swastikas. The German troops were volunteers in rented costumes. The explosions were just show pyrotechnics. The gun, artillery, and anti-aircraft fire were all blanks. Even the books that were burned were old ones that, due to wear, had been marked for disposal. The "Reichsmarks" were counterfeit German money on one side- and an ad to buy war bonds on the other.




The Winnipeg Tribune afternoon edition was satirically renamed the Lügenblatt (German for "lies sheet"). It included an "official joke" (approved by the authorities) which ordered readers to laugh or be imprisoned.



The event was announced in advance, but many were still taken by surprise. 4 years earlier a radio broadcast of "War of the Worlds" had caused widespread panic through the eastern U.S, and the Canadians didn't want a repeat. The days leading up to the "invasion" were filled with newspaper and radio warnings that it would be a staged event. Even people in neighboring Minnesota, which received CBC radio, were told.

As the invasion continued, a large map of Manitoba was posted at the intersection of Portage & Main streets in the city center. When money came in to buy war bonds from different parts of the province, areas were marked as having been "recaptured" from the Germans when they met their fundraising goals.


The "war map"

The idea was the brainchild of John Draper Perrin. People in the central regions of the country were far removed from the war, and he felt that a good fundraiser would be one that made them realize what life was like for civilians in occupied countries.

All-in-all, it was a very successful event. The cost of the staged invasion was $3000, and $3.2 million in war bonds were sold during its 24 hours. The total collection for the month-long campaign was $60 million. Vancouver was so impressed that it staged a smaller invasion, with similar success, and several American cities looked into doing their own.

The invasion ended at 5:30 p.m. with a ceremonial release of prisoners, victory parade, and speeches. The only real casualties of the day were a Canadian soldier who sprained his ankle, and a housewife who cut her thumb while cooking during the early-morning blackout.

Monday, February 18, 2013

Today's pop quiz

You've won $75,000 in the state lottery! To celebrate, you:

A. Go out to dinner, then pay off some bills.

B. Go on a cruise (preferably one with working toilets).

C. Buy that Prius you've had your eye on for years.

D. Buy some meth, marijuana, and bongs, then blow up your house.

3 Act Drama

Act I: Tuesday, February 5th.

Mary: "Dr. Grumpy's office, this is Mary."

Ms. Frantic: "I need to get in right away! The toes on my left foot are numb, and I went to ER! They told me I should see a neurologist."

Mary: "Okay... We can see you on Thursday, the 7th, or..."

Ms. Frantic: "THIS IS URGENT! I COULD BE DYING OR SOMETHING! I NEED TO GET IN TODAY!!!"

Mary: "Thursday is our next opening, I'm sorry."

Ms. Frantic: "That's crazy! I need help! I'm going to call another doctor!"

Click



Act II: Tuesday, February 12th

Mary: "Dr. Grumpy's office, this is Mary."

Ms. Frantic: "I called a week ago, and couldn't get in, and my left toes are still numb, and I really need to see a doctor!"

Mary: "Okay... We can see you this Friday, the 15th, or..."

Ms. Frantic: "WHY CAN'T ANYONE HELP ME? I NEED TO GET IN TODAY!!!"

Mary: "When you called last week you said you were going to find another doctor."

Ms. Frantic: "They couldn't get me in before Friday, the 15th, either, and I want to be seen today!"

Mary: "Sorry, but we can't get you in before then, either."

Ms. Frantic: "Why doesn't anyone care anymore?"

Click



Act III:  Morning, Friday, February 15th.

Mary: "Dr. Grumpy's office, this is Mary."

Ms. Frantic: "I changed my mind! I want that appointment you have for today!"

Mary: "I'm sorry, it's been filled. We can see you next Wednesday, the 20th."

Ms. Frantic: "How could you do this to me? You should have held that spot in case I called back! You know I need to see a doctor!"

Mary: "I thought you said you had an appointment with another neurologist for today?"

Ms. Frantic: "I do! At 2:30!"

Mary: "So why are you calling us?"

Ms. Frantic: "I didn't like the way his receptionist treated me when I called to confirm the appointment this morning."

Mary: "Okay, that's your business, but we can't see you before next Wednesday."

Long pause

Ms. Frantic: "Never mind. I think I'll just cancel the appointment. My foot got better, anyway."

Click


Sunday, February 17, 2013

Sunday reruns

At the hospital last week I saw a 20-something guy for a head injury.

He had a fight with his girlfriend outside a restaurant and said he was going to teach her a lesson.

So he began repeatedly banging HIS head against the concrete sidewalk until he was covered with blood. At some point police and paramedics pulled up, and to continue proving his point, he began banging his head repeatedly on the police car's windshield until it shattered.

He then went back to smashing his head on the sidewalk, which continued until he got tasered, and then needed Valium.

The admitting diagnosis was "Self assault"

Exactly what lesson his girlfriend learned from this is unclear, but I suspect it had something to do with getting another boyfriend.

Friday, February 15, 2013

Book 'em, Danno!

Wednesday night I was doing a survey about drug reps, and one of the questions asked where I encounter them:


I must say, I LOVE the correctional facility option. In my younger days I did see patients at a prison clinic, but don't remember a drug rep ever calling there. Yesterday I asked several reps, and none of them had ever heard of it, either.

Since I'm able to fill out this survey, I have to assume they don't think I'm the one in jail. Which leaves just one option. And I'm not driving down to the hoosegow to visit a rep.*

*The odds of a rep being incarcerated depends on the pharmaceutical company they work for.

 
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